Location
Suwanee, GA
Start Date
7-5-2024 1:00 PM
End Date
7-5-2024 4:00 PM
Description
Introduction: In the United States, approximately 9,000 people suffer from snake bites per year with an estimated five deaths reported annually.1 Majority of venomous snake bites are from one of two broad classes, Crotalinae (pit vipers) or Elapidae (coral snakes). More than 99% of snake bites that occur in the United States are from pit vipers and majority of those are due to rattlesnakes. The presentation of envenomation by one of these classes of snakes is distinctly different from one another and management options rely on discerning the etiology of a patient’s snake bite. 2 The severity of a snake bite, particularly from rattlesnake, and time it takes to receive care are important factors in the clinical presentation and treatment of a patient.3 In severe cases, surgical interventions may be indicated. 4
Materials and Methods: This is a retrospective case review of a 76-year-old female who presented to the emergency department in October of 2022 an hour after a snake bite. The patient developed acute compartment syndrome and underwent fasciotomy of the volar forearm and hand and had 4 subsequent surgeries after the initial fasciotomy over the course of two months. This case illustrates the potential of developing compartment syndrome from rattlesnake bites and the importance of early intervention when managing venomous snake bites. This presentation will include the clinical presentation of compartment syndrome and the application of fasciotomy. The management and presentation of venomous snake bites will also be discussed.
Results: After 5 separate surgeries including a fasciotomy for the compartment syndrome, the patient followed with plastic surgery and occupational therapy. Her right middle finger was saved after sharp excisional debridement and full thickness graft from left hip. She followed with physical therapy.
Conclusion: Venomous snake bites from Crotalinae must be treated rapidly and aggressively to prevent progression to acute compartment syndrome. Anavip and CroFab are the current anti-venom medications available and are administered at an hourly rate until envenomation stops progressing or symptoms begin improving. Compartment syndrome is primarily a clinical diagnosis and fasciotomy is indicated if compartmental pressure is more than 30 mmHg as measured by a Stryker needle.
Embargo Period
6-24-2024
Included in
Case Review: Rattlesnake bite with compartment syndrome and fasciotomy
Suwanee, GA
Introduction: In the United States, approximately 9,000 people suffer from snake bites per year with an estimated five deaths reported annually.1 Majority of venomous snake bites are from one of two broad classes, Crotalinae (pit vipers) or Elapidae (coral snakes). More than 99% of snake bites that occur in the United States are from pit vipers and majority of those are due to rattlesnakes. The presentation of envenomation by one of these classes of snakes is distinctly different from one another and management options rely on discerning the etiology of a patient’s snake bite. 2 The severity of a snake bite, particularly from rattlesnake, and time it takes to receive care are important factors in the clinical presentation and treatment of a patient.3 In severe cases, surgical interventions may be indicated. 4
Materials and Methods: This is a retrospective case review of a 76-year-old female who presented to the emergency department in October of 2022 an hour after a snake bite. The patient developed acute compartment syndrome and underwent fasciotomy of the volar forearm and hand and had 4 subsequent surgeries after the initial fasciotomy over the course of two months. This case illustrates the potential of developing compartment syndrome from rattlesnake bites and the importance of early intervention when managing venomous snake bites. This presentation will include the clinical presentation of compartment syndrome and the application of fasciotomy. The management and presentation of venomous snake bites will also be discussed.
Results: After 5 separate surgeries including a fasciotomy for the compartment syndrome, the patient followed with plastic surgery and occupational therapy. Her right middle finger was saved after sharp excisional debridement and full thickness graft from left hip. She followed with physical therapy.
Conclusion: Venomous snake bites from Crotalinae must be treated rapidly and aggressively to prevent progression to acute compartment syndrome. Anavip and CroFab are the current anti-venom medications available and are administered at an hourly rate until envenomation stops progressing or symptoms begin improving. Compartment syndrome is primarily a clinical diagnosis and fasciotomy is indicated if compartmental pressure is more than 30 mmHg as measured by a Stryker needle.